To examine the relationship between self-blame and illness adjustment in women with breast cancer.Descriptive, correlational design.Outpatient facilities of two metropolitan medical centers.234 women diagnosed with stage I or II breast cancer.Structured and semistructured interviews using the Psychosocial Adjustment to Illness Scale (PAIS), the Global Adjustment to Illness Scale (GAIS), an attributions and blame interview, and several questions about control over the cause and course of the cancer.Self-blame, controllability, and adjustment to illness.39% of the sample reported some self-blame. Analysis of variance indicated that subjects with high levels of self-blame had poorer scores on the PAIS and GAIS.The findings indicate the need for further study of the self-blame/adjustment relationship. Researchers must clarify the characteristics that compromise adjustment in patients with breast cancer.The findings support the importance of assessing self-blame and providing information to discourage its use by patients with breast cancer.